Implementing person-centred outcome measures (PCOMs) into routine palliative care: A protocol for a mixed-methods process evaluation of The RESOLVE PCOM Implementation Strategy

Abstract

IntroductionPerson-centred outcome measures improve quality of care and patient outcomes but are used inconsistently in palliative care practice. To address this implementation gap, we developed the ‘RESOLVE Implementation Strategy’. This protocol describes a process evaluation to explore mechanisms through which this strategy does, or does not, support the implementation of outcome measures in routine palliative care practice.Methods and analysisMultistrand, mixed-methods process evaluation. Strand one will collect routine outcomes data (palliative Phase of Illness, Integrated Palliative care Outcomes Scale, Australia-modified Karnofsky Performance Status) to map the changes in use of outcome measures over 12 months (July 2021–July 2022). Strand two will collect survey data over the same 12-month period to explore how professionals’ understandings of, skills in using and ability to build organisational practices around, outcome measures change over time. Strand three will collect interview data to understand the mechanisms underpinning/affecting our implementation strategy. Thematic framework analysis and descriptive statistics will be used to analyse qualitative and quantitative data, respectively.Ethics and disseminationFor strand one, ethical approval has been obtained (Cambridge REC, REF: 20/EE/0188). For strands two and three, ethical approval has been obtained from Hull York Medical School ethics committee (2105). Tailored feedback of study findings will be provided to participating sites. Abstracts and papers will be submitted to national/international conferences and peer-reviewed journals. Lay and policy briefings and newsletters will be shared through patient and public involvement and project networks, plus via the project website.

Implementing patient-centred outcome measures in palliative care clinical practice for adults (IMPCOM): Protocol for an update systematic review of facilitators and barriers

“…The main strength of frameworks is that they organise, explain, or describe information and the range and relationships between concepts. They delineate processes and hence are useful for communication (Bradshaw et al 2021a(Bradshaw et al , 2021b. We will determine which implementation frameworks are used (if any) and how useful they are.…”

What are the anticipated benefits, risks, barriers and facilitators to implementing person-centred outcome measures into routine care for children and young people with life-limiting and life-threatening conditions? A qualitative interview study with key stakeholders

“…7,8 An estimated 21 million children and young people (hereafter 'children') worldwide with life-limiting and lifethreatening conditions (hereafter 'life-limiting') could benefit from palliative care each year. 9 Whilst there is a growing body of evidence on the use and implementation of PCOMs in adult palliative care, [1][2][3]10,11 evidence to underpin their use and implementation for children with life-limiting conditions is more limited, 2,[12][13][14] particularly outside of paediatric oncology. [15][16][17][18][19][20][21][22] Whilst there are several PCOMs (including both generic tools and condition specific measures) that have been developed, validated and implemented across paediatrics, [23][24][25] available generic tools (e.g.…”

“…Person-Centred Outcome Measures (PCOMs) are standardised questionnaires that assess the effect of a health condition or treatment on the patient, and/or their family. 1 – 3 They are usually self-completed (as with Patient Reported Outcome Measures (PROM)), or when the patient is unable, proxy-completed by a caregiver. 1 – 3 Using PCOMs can empower patients and families to raise concerns with clinicians, and support conversations and decision-making through a shared language.…”

“… 1 – 3 They are usually self-completed (as with Patient Reported Outcome Measures (PROM)), or when the patient is unable, proxy-completed by a caregiver. 1 – 3 Using PCOMs can empower patients and families to raise concerns with clinicians, and support conversations and decision-making through a shared language. 2 , 4 – 6 These processes improve quality of care and patient outcomes.…”

Person-centred care and measurement: The more one sees, the better one knows where to look

“…The advancement of PCOMs in health care is to be welcomed, as it represents an attempt at embracing all dimensions of clinical outcome assessment by placing ‘patients, their families and carers at the heart of decisions concerning the most valuable criteria in health assessment, rather than leaving assessments solely to clinicians’. 8(p7) More recently, Bradshaw et al 9 describe PCOMs as ‘ Person -centred Outcome Measures’ (my emphasis) without any clear definition or description of what is meant by person-centred as opposed to patient-centred. The development of PCOMs needs to extend far beyond a narrow perspective of pre-determined indicators of clinical effectiveness – even if those indicators have been informed by the voice of patients, families and carers as promoted by IPPOSI.…”